Government Issues National Health Insurance Regulations

The Government of the Virgin Islands has issued the Social Security (National Health Insurance) Regulations, 2015 to provide for the efficient administration of the National Health Insurance (NHI) System.

The Regulations, which set out provisions to guide the implementation of the Social Security (Amendment) Act, 2014, were published in the Gazette on December 29 and will come into operation on January 1, 2016. Procedures governing the registration of employers and beneficiaries, contributions, records, and various related provisions, are addressed.

Part II of the Regulations deals with registration. Every person residing in the Territory is required to apply for registration as a beneficiary within one month after the Regulations come into force, or within one month after taking up residence in the Territory. A beneficiary may be registered in any of the following categories: employed, self-employed, dependant spouse, dependant child, unemployed pensioner, unemployed senior, unemployed adult, indigent, ward of the state, or other dependant.

Employers have a duty to ensure that their employees are registered with NHI within the prescribed deadlines. To facilitate the registration process, from September employers were able to submit applications on behalf of employees and their dependents online or by visiting the NHI Office.

Employed persons who have not yet obtained an NHI membership card are encouraged to communicate with their employers to verify their registration status, then visit the NHI Office in the Joshua Smith Building to be photographed for a membership card.

Government employees are also encouraged to apply online using their employee numbers, or seek assistance from their Human Resources Manager, then visit the NHI Office to be photographed for membership cards.

All other residents, except persons residing in state-run institutions, are required to submit applications on behalf of themselves and their dependents to the NHI Office, using the prescribed forms (which can be downloaded from the NHI website: www.vinhi.vg
or collected at the NHI Office).

Where persons have completed the first phase of registration and require urgent care before being issued a membership card, heath care providers can verify a beneficiary’s membership status by contacting the NHI Office on dedicated phone lines that are accessible on a 24 hour basis.

Failure to register by 31st January 2016, or one month after taking up residence in the Territory, will result in a delay in coverage until contributions are fully paid up, plus a three month waiting period from the date of the application. An employer or resident who fails to register or provide appropriate notification of a change in work, family or immigration status commits an offence and is liable on summary conviction to fine not exceeding one thousand dollars, plus a further one hundred dollars for every day during which the offence has continued.

Part III of the Regulations deals with contributions. A contribution rate of 3.75% of insurable earnings is payable in respect of an employee, employer, dependant spouse, other adult dependant, or an unemployed pensioner (under age 65 where pension is the only source of income). The rate of contribution payable in respect of a self-employed person, unemployed adult (with income from other sources), and unemployed pensioner under age 65 where pension is not the only source of income is 7.5%.

The Government will make contributions on behalf of dependent children, unemployed seniors (65 or over), indigent persons and wards of the state. Residents applying to be registered as indigent persons will be required to undergo a means test administered by the Social Development Department, and must be periodically recertified.

The Regulations also specify the manner in which contributions are to be recorded and paid by employers, which is consistent with the procedures employers already follow when submitting Social Security contributions. Within 14 daysof the end of each month employers are to submit the total contributions due by the employer and his or her employees, together with a completed Premium Remittance Form. An employer failing to pay contributions due may be liable to pay a surcharge equivalent to 10% of the amount payable for each month.

All registration and contribution forms can be downloaded from the NHI website (www.vinhi.vg) or collected from the Social Security Board offices.

National Health Insurance is designed to improve health outcomes and provide financial risk protection by ensuring that every resident of the Virgin Islands will have affordable access to the health services they need.